Individual provider Active NPI

David Grigor Davtyan, MD

  • Surgery Physician
  • Glendale, CA
National Provider Identifier
1184647729
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G70030 Issued in CA
Practice address
1141 N Brand Blvd Ste 406
Glendale, CA 91202
Phone
(818) 546-1500
Fax
(818) 546-1501
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G70030 CA Primary

Addresses

Primary practice location

1141 N Brand Blvd Ste 406
Glendale, CA 91202

Mailing address

1141 N Brand Blvd Ste 406
Glendale, CA 91202-3658
Phone (818) 546-1500

Other practice location 1

436 N Bedford Dr Ste 207
Beverly Hills, CA 90210-4312
Phone (310) 652-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050207000795 CA Practitioner - General Surgery 0042261091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Geffen School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1141 N Brand Blvd
Suite 406
Glendale, CA 91202-3658
Phone (818) 546-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G70030CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David G Davtyan MD Inc a Professional Medical Corporation Surgery CurrentSince Jun 18, 2007 Accepting new patients

Locations

1141 N Brand Blvd
Ste 406
Glendale, CA 91202
Phone (818) 546-1500

1141 N Brand Blvd
Ste 300
Glendale, CA 91202
Phone (818) 546-1500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1184647729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N BRAND BLVD STE 406",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023658",
            "telephone_number": "818-546-1500",
            "fax_number": "818-546-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 N BRAND BLVD STE 406",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91202",
            "telephone_number": "818-546-1500",
            "fax_number": "818-546-1501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "436 N Bedford Dr Ste 207",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902104312",
            "country_code": "US",
            "telephone_number": "310-652-1777",
            "fax_number": "818-546-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVTYAN",
        "first_name": "DAVID",
        "middle_name": "GRIGOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G70030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.